Can you explain more about that? I broke down healthcare expenses in the US for a previous article and came to a different conclusion. Largely that it is private insurers driving up the cost of nearly every line item. If we paid for all healthcare out of pocket it would be about 20% cheaper. I also mapped out Utah's plan to offer universal healthcare for the state, it has an innovative way of replacing Medicare and Medicaid. You can find that one here if you're interested—I'd love to know your thoughts!: https://www.elysian.press/p/states-could-have-universal-healthcare
About 65% of private health insurance enrollees are in self-funded groups, where the business funds the claims and the health insurance company serves as an administrator and does not benefit from claims paid or not paid. They also often administer public insurance like Medicaid.
Ahhh yes, I see what he's saying. It's true, the cost of nearly every healthcare thing we could want to do in the US is higher in the US than elsewhere. BUT, they also do that because they can because it's paid for by insurance. Noah Smith's solution to the problem is still to do what European countries do: Negotiate for lower prices from providers as a country.
They do it because the US is a higher income country, with a shortage of medical personnel, where a GP averages about 270k per year, a specialist doctor about 400k, and a nurse practitioner about 130k. Healthcare is the fastest growing sector of the economy and we still have shortages. Cutting salaries in half is going to hurt a lot of people, many such as RNs not rich, and is not going to help shortages.
The average salary of a doctor in the UK is about 184k equivalent. Overall salaries are around half-ish of ours.
We also pay much more for drugs, which has been used to subsidize drug development. I am agnostic on whether that’s ideal or worth the impact on our own, but it is another factor in our higher level of cost.
The Utah plan is from a group in Utah, not Utah itself, and appears unlikely to pass.
Yes but there are a lot of ways we can solve this. Imagine you are a state and you have autonomy over your states economy. You look at your healthcare landscape and healthcare is too expensive. What do you do? Well one thing you could do is fund a local medical school to entice more students to enter the industry and flood the market. With a larger supply of doctors, each of them will get paid less but we will have more of them and the cost of care will go down. This is just one example of many that could get healthcare costs down, and I think small but rich states would do them if they could. At a federal level the problem is not being solved.
This is essentially my answer to all of your questions. You are bringing up the challenges with our current system: Education, healthcare, social security, and debt are all expensive. What should we do about it?
My question in return is: What would each state do to solve it if they had tax autonomy? And might that be better than the federal government trying to solve it?
Personally I’d rather see 50 labs of democracy all solving the problems in different ways unique to their own communities, so we could learn from those various solutions as we do. Just as EU countries do.
“Because we don’t have universal healthcare, we spend double what any other wealthy nation spends on healthcare per person.”
FYI, the largest source of the difference in our spending levels on healthcare is the MUCH higher salaries US healthcare workers get.
To get to the international average, we would have to cut the pay of nurses, lab techs, radiology techs, and doctors down to international averages.
Can you explain more about that? I broke down healthcare expenses in the US for a previous article and came to a different conclusion. Largely that it is private insurers driving up the cost of nearly every line item. If we paid for all healthcare out of pocket it would be about 20% cheaper. I also mapped out Utah's plan to offer universal healthcare for the state, it has an innovative way of replacing Medicare and Medicaid. You can find that one here if you're interested—I'd love to know your thoughts!: https://www.elysian.press/p/states-could-have-universal-healthcare
Noah Smith did an article in December that covers this pretty well. https://www.noahpinion.blog/p/insurance-companies-arent-the-main
About 65% of private health insurance enrollees are in self-funded groups, where the business funds the claims and the health insurance company serves as an administrator and does not benefit from claims paid or not paid. They also often administer public insurance like Medicaid.
Ahhh yes, I see what he's saying. It's true, the cost of nearly every healthcare thing we could want to do in the US is higher in the US than elsewhere. BUT, they also do that because they can because it's paid for by insurance. Noah Smith's solution to the problem is still to do what European countries do: Negotiate for lower prices from providers as a country.
They do it because the US is a higher income country, with a shortage of medical personnel, where a GP averages about 270k per year, a specialist doctor about 400k, and a nurse practitioner about 130k. Healthcare is the fastest growing sector of the economy and we still have shortages. Cutting salaries in half is going to hurt a lot of people, many such as RNs not rich, and is not going to help shortages.
The average salary of a doctor in the UK is about 184k equivalent. Overall salaries are around half-ish of ours.
We also pay much more for drugs, which has been used to subsidize drug development. I am agnostic on whether that’s ideal or worth the impact on our own, but it is another factor in our higher level of cost.
The Utah plan is from a group in Utah, not Utah itself, and appears unlikely to pass.
Yes but there are a lot of ways we can solve this. Imagine you are a state and you have autonomy over your states economy. You look at your healthcare landscape and healthcare is too expensive. What do you do? Well one thing you could do is fund a local medical school to entice more students to enter the industry and flood the market. With a larger supply of doctors, each of them will get paid less but we will have more of them and the cost of care will go down. This is just one example of many that could get healthcare costs down, and I think small but rich states would do them if they could. At a federal level the problem is not being solved.
This is essentially my answer to all of your questions. You are bringing up the challenges with our current system: Education, healthcare, social security, and debt are all expensive. What should we do about it?
My question in return is: What would each state do to solve it if they had tax autonomy? And might that be better than the federal government trying to solve it?
Personally I’d rather see 50 labs of democracy all solving the problems in different ways unique to their own communities, so we could learn from those various solutions as we do. Just as EU countries do.